Every year thousands of people visit doctors for the hernia treatment in Delhi. A hernia is a sac formed by the lining of the abdominal cavity (peritoneum). The sac passes through a hole or weak area in the strong layer of the abdominal wall surrounding the muscle, called the fascia.

The type of hernia you have depends on your location:

• Femoral hernia is a lump in the upper thigh, just below the groin. This type is more common in women than in men.
• Hiatal hernia occurs in the upper part of the stomach. A portion of the upper part of the stomach goes into the chest.
• Ventral hernia can occur through a scar if you have had abdominal surgery in the past.
• Umbilical hernia is a bump around the belly button. It happens when the muscle around the navel does not close completely after birth.
• Inguinal hernia is a lump in the groin. This type is more common in men. It can go down to the scrotum.

Causes

Usually, there is no clear cause for a hernia. Sometimes, they are presented by:

• Lift heavy objects
• Make effort when using the bathroom
• Perform any activity that raises the pressure inside the abdomen

Hernias may occur at birth, but the bump may not be noticeable until later in life. Some people have a family history of hernias.

Babies and children can develop hernias. This happens when there is a weakness in the abdominal wall. Inguinal hernias are common among children. Some children have no symptoms until they are adults.

Any activity or health problem that increases the pressure in the abdominal wall tissue and muscles can lead to a hernia, including:

• Chronic constipation and push (strain) strongly to defecate
• Chronic cough or sneezing
• Cystic fibrosis
• Enlarged prostate, effort to urinate
• Overweight
• Liquid in the abdomen
• Peritoneal dialysis
• Malnutrition
• Smoking
• Excessive effort
• Testicle that has not descended (Cryptorchidism)

Symptom

There are generally no symptoms. Some people have discomfort or pain. The discomfort may be worse when standing, straining or lifting heavy objects. Sooner or later, the most common complaint is a bulge that is sensitive and growing.

When a hernia is enlarged, it can get stuck inside the hole and lose its blood supply. This is called strangulation. Symptoms include:

• Nausea and vomiting
• Not being able to remove gas or have bowel movements

When it occurs, hernia surgery in Delhi is needed immediately.

Tests and exams

The laparoscopic surgeon in Delhi can usually see or feel the hernia when examined. You may be asked to cough, bend over, push or lift something. The hernia may enlarge when you do this.

The hernia (bump) may not be easily visible in babies and children, except when they are crying or coughing.

An ultrasound or CT scan may be done to look for a hernia.

If there is a blockage in the intestine, an x-ray of the abdomen will probably be taken.

Hernia Treatment in Delhi

Surgery is the only hernia treatment in Delhi with which a hernia can be permanently repaired. Surgery may be riskier for people with serious health problems.

The hernia surgery in Delhi repairs the weakened tissue of the abdominal wall (fascia) and closes any hole. Most hernias are closed with stitches and sometimes with patches of fabric to seal the hole.

An umbilical hernia that does not heal on its own when a child is 5 years old will probably be repaired.

Expectations (prognosis)

The clinical outcome (outcome) for most hernias is generally good with hernia treatment in West Delhi. It is uncommon for a hernia to reappear. Surgical hernias are more likely to reappear.

Possible complications

Rarely, the repair of an inguinal hernia can damage the structures involved in the functioning of a man’s testicles.

Another risk of surgery for a hernia is nerve damage, which can lead to numbness in the groin area.

If a part of the intestine was trapped or strangled before hernia surgery, intestinal perforation or death of the intestine may occur.

When to contact a medical professional

Check with your doctor immediately if:

• You have a painful hernia and the contents cannot be reintroduced into the abdomen using gentle pressure
• You have nausea, vomiting or fever along with the painful hernia
• You have a hernia that turns red, purple, dark or changes color

Call your doctor if:

• You have pain, swelling or a lump in the groin
• Has a lump or swelling in the groin or belly button, or that is related to a previous surgical incision

Prevention

To prevent a hernia:

• Use appropriate techniques to lift the weight.
• Lose weight in case of overweight.
• Relieve or avoid constipation by eating a lot of fiber, drinking plenty of fluids, going to the bathroom as soon as you feel like it and exercising regularly.
• Men should see urologist in Delhi if they make an effort to urinate, as this can be a symptom of an enlarged prostate.

Small Bowel Surgery in Delhi is done to remove a part of the small intestine. This is done when part of it is clogged or sick. The small intestine is also called the small intestine. Most of the digestion (breakdown and absorption of nutrients) of the food you eat takes place there.

Description

You will receive general anesthesia at the time of surgery. This will keep you asleep and you won’t feel pain.

Small bowel surgery in Delhi can be performed laparoscopically or with open surgery. If you have laparoscopic surgery:

• The laparoscopic surgeon in Delhi makes 3 to 5 small cuts (incisions) in your lower abdomen. A medical device called a laparoscope is inserted through one of the cuts. This device is a thin and illuminated tube with a camera at the end. This allows the surgeon to see inside the abdomen. Other medical instruments are introduced through the other cuts.
• It is also possible that a cut of approximately 2 to 3 inches (5 to 7.6 centimeters) be made if the surgeon needs to insert the hand into the abdomen to palpate the intestine or remove the affected segment.
• Your abdomen is filled with harmless gas to expand it. This facilitates visualization and work in the area.
• The affected part of the small intestine is located and removed.

If you had an open surgery:

• The surgeon makes a cut of 6 to 8 inches (15 to 20.3 centimeters) in the middle part of your abdomen.
• The affected part of the small intestine is located and removed.

In both types of surgery, the following steps are:

• If enough healthy small intestine remains, the ends are sutured or stapled. This is called anastomosis. This is done to most patients.
• If there is not enough healthy small intestine to reconnect, the surgeon makes an opening called a stoma through the skin of your abdomen. The small intestine is fixed to the outer wall of your abdomen. The stool will pass through the stoma into a drainage bag that is outside your body. This is called ileostomy. The ileostomy can be short term or permanent. Resection of the small intestine usually takes between 1 and 4 hours. Why the procedure is performed

Small bowel resection is used to treat:

• A blockage in the intestine caused by scar tissue or congenital (birth) deformities
• Bleeding, infection or ulcers caused by inflammation of the small intestine from conditions such as Crohn’s disease
• Cancer
• Carcinoid tumor
• Injuries to the small intestine
• Meckel’s diverticulum (a pouch in the wall of the lower part of the small intestine that is present at birth)
• Non-cancerous (benign) tumors
• Precancerous polyps

Risks

The risks of anesthesia and surgery in general are:

• Drug reactions
• Respiratory problems
• Blood clots, bleeding, infection

The risks of this surgery include:

• Tissue protrusion through the incision, called surgical herniation
• Damage to nearby organs in the body
• Diarrhea
• Problems with your ileostomy
• Scar tissue may form in the abdomen and cause blockage in the intestines
• Short bowel syndrome (when it is necessary to remove a large amount of the small intestine), which can lead to problems absorbing important nutrients and vitamins
• Chronic anemia
• Separation of the ends of the intestine that are sutured (anastomotic filtration, which can be fatal)
• Wound opening
• Wound infection

Before the procedure

Always tell your surgeon or nurse what medications you are taking, including drugs, supplements or herbs that you have bought without a prescription. Talk to your surgeon or nurse about how the surgery will affect the following aspects:

• Intimacy and sexuality
• Pregnancy
• sports
• Job

During the 2 weeks before surgery:

• You may be asked to stop taking blood thinners. These include acetylsalicylic acid ( aspirin ), ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) and others.
• Ask your surgeon what drugs you should take even the day of surgery.
• If you are a smoker, try to quit. Smoking increases the risk of problems such as a slow recovery. Ask the doctor or nurse to help you leave.
• Tell the surgeon immediately if you have a cold, flu, fever, herpes outbreak or another illness before surgery.
• You may be asked to undergo an intestinal preparation to remove all feces from your intestines. This may involve eating a liquid diet for a few days and using laxatives.

The day before surgery:

• You may be asked to drink only clear liquids such as broth, clear juice and water.
• Follow the instructions on when to stop eating and drinking.

On the day of surgery:

• Take the medications that your surgeon indicated with a small sip of water.
• Arrive at the hospital on time.

After the procedure

You will be in the hospital for 3 to 7 days. You may have to stay longer if your surgery was an emergency operation. You may also need to stay longer if a large amount of your small intestine was removed or if you have problems. On the second or third day, you can probably drink clear liquids. Thicker liquids and then soft foods will be added as your intestines start working again. If a large amount of your small intestine was removed, you may need to receive liquid nutrition through a vein (IV) for a while. A line will be placed in your neck or upper chest to provide nutrition. After you go home, follow the instructions on how to take care of yourself until it heals.

Expectations (prognosis)

Most people who undergo resection of the small intestine recover completely. Even with an ileostomy, most can perform the activities they were doing before the operation. These include most sports, travel, gardening, hiking and other outdoor activities, as well as most types of work. If a large part of your small intestine was removed, you may have problems with loose stools and getting enough nutrients from the food you eat. If you have a prolonged (chroni) illness, such as cancer, Crohn’s disease or ulcerative colitis, you may need ongoing medical treatment.

It is a surgery to remove all or part of the large intestine. This large bowel surgery in Delhi is also called colectomy. The large intestine is also called the colon.

• The removal of the entire colon and rectum is called a proctocolectomy.
• The removal of the entire colon, but not the rectum, is called subtotal colectomy.
• The removal of part of the colon, but not the rectum, is called a partial colectomy.

The large intestine connects the small intestine with the anus. Normally, stool passes through the large intestine before leaving the body through the anus.

Description

You will receive general anesthesia at the time of surgery. This will keep you asleep and pain-free. The surgery can be performed laparoscopically or with open surgery. Depending on which surgery you have, the surgeon will make one or more cuts (incisions) in the abdomen. If you have laparoscopic surgery:

• The laparoscopic surgeon in Delhi makes 3 to 5 small cuts (incisions) in your abdomen. A medical device called a laparoscope is inserted through one of the cuts. This device is a thin and illuminated tube with a camera at the end. This allows the surgeon to see inside the abdomen. Other medical instruments are introduced through the other cuts.
• It is also possible that a cut of approximately 2 to 3 inches (5 to 7.6 centimeters) be made if the surgeon needs to insert the hand into the abdomen to palpate the intestine or remove the affected segment.
• Your abdomen is filled with a harmless gas to expand it. This facilitates visualization and works in the area.
• The surgeon examines the organs of your abdomen to see if there is a problem.
• The affected part of the large intestine is located and removed. Some lymph nodes may also be removed.

If you had an open surgery:

• The surgeon makes a cut of 6 to 8 inches (15.2 to 20.3 centimeters) in the lower part of your abdomen.
• Your abdomen organs are examined to see if there is a problem.
• The affected part of the large intestine is located and removed. Some lymph nodes may also
  be removed.

In both types of surgery, the following steps are:

• If enough healthy large intestine remains, the ends are sutured or stapled. This is called anastomosis. This is done to most patients.
• If there is not enough healthy large intestine to reconnect, the surgeon makes an opening called a stoma through the skin of your abdomen. The colon is fixed to the outer wall of your abdomen. The stool will pass through the stoma into a drainage bag that is outside your body. This is called a colostomy. The colostomy can be short term or permanent.

The colectomy usually takes between 1 and 4 hours. Why the procedure is performed Resection of the large intestine is used to treat many conditions, including:

• A blockage in the intestine due to scar tissue
• Colon cancer
• Diverticular disease (large intestine disease)

Other reasons for a bowel resection are:

• Familial polyposis (polyps are growths in the lining of the colon or rectum)
• Lesions that cause damage to the large intestine.
• Intussusception (when one part of the intestine is inserted into another).
• Precancerous polyps
• Intense gastrointestinal bleeding
• Twisting of the intestine (volvulus).
• Ulcerative Colitis.
• Bleeding from the large intestine
• Deficit in nerve function of the large intestine

Risks

The risks of anesthesia and surgery in general are:

• Drug reactions
• Respiratory problems
• Blood clots, bleeding, infection

The risks of this surgery are:

• Bleeding into the abdomen
• Tissue protrusion through the incision called surgical hernia.
• Damage to nearby organs in the body.
• Damage to the ureter or bladder.
• Problems with the colostomy.
• Scar tissue that forms in the abdomen and causes blockage in the intestines.
• The edges of the intestine that are sutured open (anastomotic filtration that is life-threatening).
• Wound opening
• Wound infection.
• Peritonitis

Before the procedure

Always tell your surgeon or nurse what medications you are taking, including drugs, supplements or herbs that you have bought without a prescription. Talk to your laparoscopic surgeon in Delhi about how the surgery will affect the following aspects:

• Intimacy and sexuality
• Pregnancy
• sports
• Job

During the 2 weeks before surgery:

• You may be asked to stop taking blood thinners. These include acetylsalicylic acid ( aspirin ), ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn) and others.
• Ask your surgeon what drugs you should take even the day of surgery.
• If you are a smoker, try to quit. Smoking increases the risk of problems such as a slow recovery. Ask the doctor or nurse to help you leave.
• Tell the surgeon immediately if you have a cold, flu, fever, herpes outbreak or another illness before surgery.
• You may be asked to undergo an intestinal preparation to remove all feces from your intestines. This may involve eating a liquid diet for a few days and using laxatives.

The day before surgery:

• You may be asked to drink only clear liquids such as broth, clear juice and water.
• Follow the instructions on when to stop eating and drinking On the day of surgery:
• Take the medications that your surgeon indicated with a small sip of water.
• Arrive at the hospital on time.

After the procedure

You will be in the hospital for 3 to 7 days. You may have to stay longer if the colectomy was an emergency operation.

You may also need to stay longer if a large amount of your large intestine was removed or if you have problems.

By the second or third day, you can probably drink clear liquids. Slowly, thicker liquids will be added and then soft foods as your intestines start working again. After you go home, follow the instructions on how to take care of yourself while recovering.

Expectations (prognosis)

Most people who undergo resection of the large intestine recover completely. Even if you have a colostomy, most can do the activities you were doing before the operation. This includes most sports, travel, gardening, hiking, other outdoor activities and most types of work. If you have a prolonged (chronic) disease, such as cancer, Crohn’s disease or ulcerative colitis, you may need ongoing medical treatment.

The intervention of Sleeve gastrectomy in Delhi or “vertical gastroplasty calibrated with gastric resection” involves removing a large part of the stomach to form a tube.

Foods will first be slowed down while in the tube and then evacuated very quickly in the small intestine.

The Sleeve acts by several mechanisms that combine:

• A restriction (such as gastroplasty): the volume and size of the stomach are decreased, the passage of food is very slow, but there is no change in the digestion of food.
• A decrease in the rate of ghrêline, which is the hormone of hunger, which leads to a lack of interest in food
• A modification of the bacterial flora of the esophagus, which leads to a happy change in taste for food: patients are much less attracted to meat and starchy foods, and more to fish and green vegetables.

Advantages & Disadvantages

• Sleeve is the most frequently performed bariatric surgery.
• The Sleeve is a complex procedure , with an average hospital stay of 2 to 3 days.
• Sleeve is an intervention performed for over 15 years, its long-term results (10 years) are beginning to be known.
• Weight loss is usually around 4 kg per month, during the first 6 months, then 2 to 4 kg per month.
• Weight loss at 10 years is approximately 65% ​​to 70% of excess weight, which is an intermediate outcome between gastroplasty and bypass.
• Undernutrition and vitamin deficiencies are rare. 
  In our team, we prescribe vitamins and nutritional supplements for 3 months and a biological assessment at 3 months, 6 months and 1 year.
  This biological assessment is usually normal, It sometimes shows small vitamin deficits that are easily compensated by oral route.
• The Sleeve is not reversible. However, the tube will expand gradually and will no longer be effective after 5 to 7 years.
• Dietary habits should be changed
  3 meals and possibly 2 snacks.
• Vomiting is quite rare.
• Regular monitoring by a multidisciplinary team is mandatory.

Hospitalization

THE DAY BEFORE

• You are hospitalized around 17 hours if your intervention is planned in the morning.
• You can eat normally.
• You will be fasting from midnight.

D-DAY

• You have been fasting since midnight. If your intervention is scheduled in the afternoon, you can return in the morning, a light breakfast is possible before 8 am.
• The procedure requires a complete general anesthesia, it is performed by laparoscopy, it lasts 1 to 2 hours.
• After the procedure, you will spend a few hours in the recovery room, then we will take you back to your room.
• You will not have a probe in your nose. A small tube (called Redon) is put in place at the end of the procedure, it comes out through a small hole in the abdomen. Redon is used to aspirate secretions and will be removed on D2.
• Pain medications will be administered by the vein.
• The evening of the intervention: fasting.

THE DAY AFTER THE INTERVENTION (J1)

• You will be able to drink a little water after agreement of the surgeon.
• Pain medications will be administered by the vein.
• A physiotherapist will help you to sit down and make a passive mobilization.

Discharge

You can leave the facility late in the morning, usually D1 or D2 after the procedure.

Your surgeon will give you:

• An order of the different medications needed after the procedure.
• A prescription for scar care and anticoagulant injections.
• A work stoppage of 2 or 3 weeks, depending on your general condition and the arduousness of your professional activity.
• A detailed program for the gradual recovery of your diet.

Precautions

The first month

The first month will allow you to get used to your new stomach. Eat very slowly, because you should not force the small stomach, which is healing.

After the first month

EAT IN CALM AT REGULAR HOURS

• Split your food intake into three meals (and possibly one or two snacks).
• Vary your diet.
• Eat only small pieces.
• Chew for a long time, swallow several times.
• Take the time to enjoy your meal. Remember that digestion begins in your mouth.
• Drink as little as possible during your meals
• When you feel full, stop eating.
• Watch your teeth

One more teaspoon may make you vomit. You have only a mini stomach, do not forget it.

IF YOU VOMIT, WHICH IS A RARE EVENT WITH THE SLEEVE:

• Either you have eaten too much
• Either you have eaten too fast
• Either you have eaten too much chunks
• Either you have not chew enough
• Either you swallowed too fast

BETWEEN MEALS

Drink outside meals often, in small amounts, even without thirst.Regard regular physical activity , recreation and endurance.
The simplest regular physical activity is walking: walk at a good pace but at your own pace, ideally 3 times 30 to 40 minutes a week.
A physiotherapist can help you. After the first month, you can resume the sport without any problem.Respect sufficient hours of sleep.
Do you eventually accompany the level of ” stress management ”

FOLLOW YOUR DOCTOR REGULARLY

In addition to your daily intake of vitamins and trace elements, your doctor will encourage you to optimize your diet in the sense of a better intake of iron and calcium (possibly after a dosage of these elements) .Also attention to a possible protein malnutrition. If you do not bring enough protein to your diet, you will lose weight on your muscle mass, while it would be better to lose weight on your fat or water of your body. At worst, you can suffer protein malnutrition, with decreased immune defenses and fatigue, anemia, increased susceptibility to infections. Good luck !

Any fluid-filled lesion is called a cyst. When these cysts are located in the liver they are called hepatic
cysts. On numerous occasions, these do not produce symptoms and are diagnosed after performing a liver scan using an ultrasound or CT scan. Many people often have small cysts that do not need treatment or follow-up by a medical professional. On other occasions, the cysts may be multiple and larger, with parasitic, hereditary or other origins, which may need more intensive follow-up. This type of patient will need other diagnostic tests and eventually a medical-surgical liver cysts treatment in Delhi.

Types of liver cysts

• Simple cyst: most frequent and totally benign type of cyst composed of clear fluid that does not communicate with intrahepatic bile ducts.
• Polycystic liver disease: a disease characterized by the development of multiple cysts in the liver. It is usually related to the presence of several cysts in the kidney.
• Hydatid cyst: The parasite called Echinococcus granulosus, which can be spread through infected dogs, is the cause of this type of cyst.
• Tumors: Sometimes the tumors take on the appearance of liver cysts, they develop in the intrahepatic bile ducts.
• Biliary cysts: these consist of dilations of the intrahepatic biliary branches that give rise to the appearance of a cyst.

Disease prognosis

The prognosis is favorable in most cases when a liver cyst is diagnosed even if they cause pain or increase in size.

Symptoms of the liver cyst

In most cases, hepatic cysts do not show symptoms but occur unpredictably. Smaller cysts may not be diagnosed until they increase in size and the patient experiences pain and other discomforts. In cases where the patient feels a sudden and sharp pain, in the upper part of the stomach means that the liver cyst is bleeding. Hepatic cysts tend to develop anywhere in the liver but to form more frequently in the right lobe of the liver.

By means of a physical examination from the outside of the stomach, the growth of a certain cyst can be diagnosed. Medical tests for the liver cyst before the onset of pain or enlargement of the abdomen the specialist will perform a physical examination to diagnose the pathology. It is necessary to note that there are certain diseases that may be associated with liver cysts:

• Polycystic liver diseases.
• Autosomal dominant polycystic kidney disease (ERPAD).
• Von Hippel Lindau disease.
• Ultrasound, computed tomography, and images by MRI can make a differential analysis.

Through the images, hepatic cysts can be identified as round or oval structures with defined margins. At the same time, a homogeneous hypo-coughing can be observed, among other characteristics.

Finally, the specialist must also perform a blood test to rule out the option of the presence of parasites.

What are the causes of the liver cyst?

The appearance of hepatic cysts is related to bile duct malformations, but their exact origin is unknown. Over the years some people develop liver cysts, while others suffer from birth. Being asymptomatic. These cysts are not diagnosed until the patient suffers pain and their specialist performs the appropriate tests indicated above. Renal insufficiency or a malfunction of the spleen of the gallbladder may be other causes of the appearance of a liver cyst. Because the accumulation of toxins can cause alterations in liver function. The formation of these cysts is created from an increase in differentiated liver cells, which grow and are distributed in a disorganized manner.

Can it be prevented?

Most liver cysts originate through the genetic inheritance of each person. However, the greatest risk occurs in the bacterium called Echinococcus granulosus, which can cause liver cysts to appear. However, there are several preventive measures specified below.

• The dogs (dogs, wolves, jackals, coyotes…) are the main carriers of Echinococcus granulosus, therefore it is important that those dogs that have not received the necessary vaccines or a deworming process are not petted or kissed.
• It is very important that domestic dogs receive each and every vaccine.
• Wash fruit and vegetables properly before eating.
• Maintain proper hand hygiene by washing frequently and always drink bottled water.

Liver Cysts Treatment in Delhi

In many cases, liver cysts do not need treatment. The laparoscopic surgeon in Delhi can perform an ultrasound to visually control the larger cysts (larger than 4 cm). If the cyst does not grow after 2 or 3 years, it will not be necessary to continue monitoring the cyst. On the one hand, surgery will be necessary for those situations in which the cyst is large and causes pain to the patient. There are different surgical options, and among them, the cyst wasting, by surgery or laparoscopy. On the other hand, puncture cyst drainage is not a recommended option, since the cyst can reproduce.

The hemicolectomy in Delhi is the surgical removal or resection of a diseased part of the large intestine or colon. This surgery is recommended as a treatment for various pathological processes. Among them, the most common are cancer, diverticulitis, intestinal obstruction, ulcer activated is eased such as ulcer active col it is that does not respond to treatment, etc.

The intervention is carried out under general anesthesia. Schematically, it would consist of making an incision in the abdomen, through which the diseased part of the colon is removed. Next, the two healthy ends are sutured and the incision is closed.

When it is necessary to remove the entire colon and rectum, the operation is called a proctocolectomy. Resection of the large intestine can be performed with open surgery or by a laparoscopic procedure.

What types of hemicolectomy in Delhi exist?

• Right hemicolectomy

If the tumor is located in the cecumor in the ascending colon, aright hemicolectomy is performed.

This consists of the removal from 10-15cm. from terminal ileum to the proximal third of the transverse colon, including the corresponding blood vessels and lymph nodes. To restore intestinal transit, an ileocolicanastomos is with the manual or mechanical suture is performed.

• Left hemicolectomy

If the tumor is located in the descending colonor sigma, a left hemicolectomy in Delhi is performed.

This involves the removal of the descending colon and sigma to the rectosigmoid junction, including the inferior mesenteric artery and vein. The anastomosis can be performed manually or mechanically.

Usually, it is done mechanically by means of a stapler that, from the anus, reaches the sectional area of the colon and crimps with a head that is inserted into the other end of the colon.

• Segmental colectomies

For tumors located in the transverse colon or splenic angle, it is possible to perform less extensive resections, but always with adequate margins and removing the main vascular pedicle.

Laparoscopy hemicolectomy in Delhi

It is the surgical technique used for the treatment and management of cancer and other diseases of the colon. Making very small incisions not only has aesthetic advantages, but it also reduces postoperative infections and reduces postoperative pain.

As a consequence, the fasting period, the bedtime period, the hospital admission time and the time of work leaves are shorter. The risk of hernias in the incisions is also reduced as they are smaller. Therefore the postoperative discomfort is minor and the return to normal activity very fast.

How is the recovery?

Regarding the postoperative period, the majority of patients remain in the hospital for five to seven days, while the full recovery from surgery can last from one to two months. This recovery time is generally shorter when bowel resection is treated by laparoscopic technique compared to traditional open surgery.

During the first days after surgery, food is restricted. The patient will then start with a diet first liquid and then soft.

It should be noted that, by removing all or part of the colon, bowel habits can be modified and diarrhea tendency may appear. On other occasions, constipation occurs.

The intervention of the gastric bypass surgery in Delhi involves reducing the volume of the stomach and modifying the food circuit.

Food does not pass through the stomach and the upper part of the digestive tract, it goes directly into the middle part of the small intestine.

There are 2 types of bypass:

• The classic Bypass
• The mini Bypass

The mini bypass is a recent evolution of the bypass, its theoretical advantages are:

• An easier technical realization, so a shorter intervention, ½ h to 1 hour.
• Total reversibility, relatively simple to achieve technically by laparoscopy.

The main disadvantages of the mini bypass seem to be:

• Gastroesophageal reflux (this problem should be resolved by using a longer gastric tube).
• The weight loss at 1 year seems the same as with the bypass, as the weight loss at 5 years. The results at 10 years are not known.

Very important: the mini bypass has “mini” only its name: its mode of action and its consequences on the body are the same as with the bypass, monitoring and taking vitamins, in the long run, are essential.

The bypass acts by several mechanisms that combine:

• A restriction (such as gastroplasty)
• Malabsorption: foods are less digested
• Dumping Syndrome: (The ingestion of highly sugary foods in large quantities causes a feeling of general malaise and an acceleration of the pulse, these foods must, therefore, be taken in small quantities)
• A decrease in the rate of ghrêline, which is the hormone of hunger, which leads to a lack of interest in food (attention: this mechanism of action is not effective on any compulsions).

Advantages & Disadvantages

• The gastric bypass surgery in Delhi is a complex procedure, with a hospital stay of 2 to 4 days on average.
• The bypass must lead to a very important weight loss of
  the order of 5 kgs per month, during the first 6 months, then a weight loss of 2 to 4 kgs per month. It is indicated for Body Mass Indexes greater than 45. According to scientific data, the bypass makes – on average – 70% of excess weight lost in 1 year.
• Undernutrition and vitamin deficiencies are not uncommon
  Oral supplementation with vitamins and trace elements is essential. The modification of the alimentary circuit is responsible for the reduction of the digestion of the so-called “fat-soluble” vitamins (vitamins A, D, EK), vitamin B12 and certain nutrients and oligo-elements. These different products must be brought in addition to the diet, in the form of capsules.
• The class bypass is difficult to reverse, the mini bypass is relatively easily reversible.
• Food comfort is better than gastroplasty
  Vomiting is rare.
• Dietary habits should be changed
  3 meals and possibly 2 snacks.
• Sugary snacking is not well tolerated, especially with the conventional bypass
  because of ”dumping syndrome”, which is considered a benefit by the operated patients.
• Regular monitoring by a multidisciplinary team is mandatory. 
  3 Blood tests are necessary the first year, then 1 to 2 blood tests a year, to look for vitamin deficiency, anemia, undernutrition.

Hospitalization

THE DAY BEFORE

• You are hospitalized around 17 hours if your hospitalization is planned in the morning.
• You can eat normally.
• You will be fasting from midnight.

D-DAY

• If your intervention is scheduled in the afternoon, you can return in the morning, a light breakfast is possible before 8 am.
• The procedure requires complete general anesthesia, it is performed by laparoscopy, it lasts 2 to 3 hours.
• After the gastric bypass surgery in Delhi, you will spend a few hours in the recovery room before being taken back to your room.
• You will not have a probe in your nose. A small tube (called Redon) is put in place at the end of the procedure, it comes out through a small hole in the abdomen. Redon is used to aspirating secretions and will be removed on D2 or D3.
• Pain medications will be administered by the vein.
• The evening of the intervention: fasting.

THE DAY AFTER THE INTERVENTION (J1)

• You will be able to drink a glass of water after the assessment of the laparoscopic surgeon in Delhi.
• Pain medications will be administered by the vein.
• A physiotherapist will help you to sit down and make a passive mobilization.

Discharge

You can leave the facility late in the morning, usually D1 or D2 after the procedure.

Your surgeon will give you:

• An order of the different medications needed after the procedure.
• A prescription for scar care and anticoagulant injections.
• A work stoppage of 2 or 3 weeks, depending on your general condition and the arduousness of your professional activity.
• A detailed program for the gradual recovery of your diet.

Precaution

The first month

The first month will allow you to get used to your new digestive circuit.
Eat very slowly, because you must not fill the small stomach, which is healing.

After the first month

EAT-IN CALM AT REGULAR HOURS

• Split your food intake into three meals (and possibly one or two snacks)
• Vary your diet
• Eat only small pieces
• Chew for a long time, swallow several times
• Take the time to enjoy your meal. Remember that digestion begins in your mouth
• Drink as little as possible during your meals
• When you feel full, stop eating
• Watch your teeth

A teaspoon more can make you vomit. You have only a mini stomach, do not forget it.

IF YOU VOMIT

• Either you have eaten too much
• Either you have eaten too fast
• Either you have eaten too many chunks
• Either you have not chew enough
• Either you swallowed too fast

BETWEEN MEALS

Beware of Dumping Syndrome: ingestion of an unusual amount of sugary products can lead to general discomfort.

• Avoid sugary drinks and, in principle, soft drinks.
• Drink outside meals often, in small amounts, even without thirst.

Resume regular physical activity, recreation, and endurance.

The simplest regular physical activity is walking: walk at a good pace but at your own pace, ideally 3 times 30 to 40 minutes a week.

A physiotherapist can help you. After the first month, you can resume the sport without any problem.

Observe adequate hours of sleep.

FOLLOW YOUR DOCTOR REGULARLY

In addition to your daily intake of vitamins and trace elements, your doctor will encourage you to optimize your diet in the direction of a better intake of iron and calcium (possibly after a dosage of these elements).

Attention also to possible protein malnutrition. If you do not bring enough protein to your diet, you will lose weight on your muscle mass, while it would be better to lose weight on your fat or water of your body. At worst, you can suffer protein malnutrition, with decreased immune defenses and fatigue, anemia, increased susceptibility to infections. Good luck!

Cholecystectomy in Delhi is an operation that involves the gallbladder removal surgery in Delhi when it is damaged. Generally, the procedure is performed to prevent damage to the gallbladder and liver when gallstones appear that obstruct the ducts through which the bile flows. Cholecystectomy can be performed by open surgery or laparoscopy.

What is the gallbladder?

• The gallbladder is a pear-shaped organ that rests under the right side of the liver.
• Its main function is the collection and concentration of a digestive fluid (bile) produced by the liver. Bile is released by the gallbladder after eating, aiding digestion. Bile travels through thin tubes (bile duct) into the small intestine.
• In most patients, gallbladder removal is not associated with any digestion damage.

What are the causes of gallbladder problems?

• Gallbladder problems are usually caused by the presence of stones, which are small stones composed mainly of cholesterol and bile salts, and are formed in the gallbladder or bile duct.
• It is not known because some people form stones.
• There is no known measure to prevent stones.
• These stones can obstruct the outflow of gallbladder, causing inflammation and causing acute abdominal pain, vomiting, indigestion, and occasionally, fever.
• If the stone blocks the bile duct, jaundice (yellowing of the skin) may occur.

How are these problems found and treated?

After the patient has symptoms …

• Ultrasound (ultrasound) is the most used method to find stones.
• In a few more complex cases, other X-ray tests can be used to evaluate the gallbladder.
• The stones are not expelled by themselves. Some may be handled temporarily with drugs or with special diets, to suspend fat absorption. This treatment has a low success rate in a short time and the symptoms will continue until the gallbladder is removed.
• Surgical removal of the gallbladder is the most recognized treatment over time and safe for gallbladder pathology.

Description of The Process of Gallbladder Removal Surgery in Delhi:

In both cases, the procedure is usually performed with general anesthesia and lasts one hour.

Laparoscopic cholecystectomy in Delhi is performed with small incisions and requires a maximum hospital admission of one day.

Traditional cholecystectomy requires a larger incision to remove the gallbladder and requires patients to stay in the hospital for several days after the procedure.

BEFORE OPERATION:

The patient must undergo a prior assessment to assess his case and the specific characteristics of the intervention.

In addition, patients will have to undergo a pre-operative study that includes a blood test, an electrocardiogram, etc.

On the other hand, if you suffer from a chronic illness or if you usually take medication, especially anticoagulants, you must communicate it to the laparoscopic surgeon in Delhi before the procedure.

AFTER THE INTERVENTION:

After the procedure, patients must follow a special diet based on fluids and sweet foods for three to four weeks.

During the first days, patients may experience nausea and discomfort. It is therefore recommended to observe a moderate rest period.

Food and normal activity will gradually begin again.

Are There Risks Related to Laparoscopic Cholecystectomy?

There are risks related to any kind of operation, the vast majority of laparoscopic cholecystectomy patients experience few or no complications and quickly return to their normal activities. It is important to remember that before undergoing any type of surgery (either laparoscopic or open), you should ask your surgeon about your experience and training. The risks of laparoscopic cholecystectomy are less than the risks of leaving a condition without treatment.

Complications of Laparoscopic Cholecystectomy in Delhi are uncommon but may include bleeding, infection, pneumonia, blood clots or heart problems. An inadvertent lesion of a nearby structure such as the common bile duct or duodenum may occur and may require another procedure to repair it. Bile leaks to the abdomen from the ducts that carry bile from the liver to the duodenum have been described.

What happens after Cholecystectomy?

• Gallbladder removal surgery in Delhi is major abdominal surgery and some amount of pain can be felt. Nausea and vomiting are not uncommon.
• Once fluids or diet are tolerated, patients leave the hospital the same or the next day after laparoscopic gallbladder surgery.
• The activity depends on how the patient feels. Walking is advised. Patients can remove their bandages and bathe the day after surgery.
• Patients will probably be able to return to their normal activities within a week, including driving a car, climbing stairs, lifting light objects and working.
• In general, recovery is progressive from when the patient returns home.
• The presence of fever, yellowing of the eyes or skin, worsening of abdominal pain, bloating, nausea and persistent vomiting, or drainage from any of the wounds are indications that a complication may have occurred. You should contact your surgeon in these circumstances.
• You can request a control appointment within two weeks after surgery, even if your postoperative period has run smoothly.

Laparoscopic adrenalectomy in Delhi should be considered the procedure of choice for the surgical treatment of benign adrenal diseases. laparoscopic adrenalectomy has a time that is less compared to that of the open approach and also has all the advantages of laparoscopic surgery (shorter hospital stay, shorter convalescence time, less postoperative pain, etc.). The only premise to perform this type of intervention is a laparoscopic surgeon in Delhi with experience in advanced laparoscopic surgery and a good knowledge of the anatomy of the adrenal gland.

What are the adrenal glands?

What is adrenalectomy?

Adrenalectomy in Delhi involves the removal of a gland located above the kidney called adrenal gland, being rare to have to remove both(right and left). If necessary medical treatment is administered to control the possible hormonal alterations during the surgery or after the intervention.

Some times it may be necessary to extend the resection to the organs and it is possible that after the operation is a hormonal deficit that requires replacement medical treatment.

It is possible that during the surgery you have to make modifications to the procedure by intraoperative findings to provide the most appropriate treatment.

The intervention requires the administration of anesthesia and it is possible that during or after the intervention the use of blood and/or blood products is necessary.

Purpose of the adrenalectomy in Delhi and benefits that are expected to be achieved

This procedure is intended to prevent excessive growth of the gland, alterations general and neighboring organ sand/or control hormone levels.

Who needs adrenalectomy in Delhi?

The most common cause for adrenalectomy in Delhi is because a tumor is discovered in an adrenal gland that produces an excess of one of the hormones. The vast majority of these tumors are benign. Each type of tumor produces an excess of a certain hormone, so the symptoms can be varied. The main tumors of the adrenal glands are:

• Pheochromocytomas: produce an excess of adrenaline or norepinephrine. They can cause an increase in blood pressure, tachycardia, and palpitations or very severe headache. They usually increase blood sugar.
• Aldosteronomas: produce an excess of aldosterone. They cause a significant increase in blood pressure and a decrease in potassium in the blood.
• Secretory corticosteroid tumors: they produce a disease called Cushing’s syndrome, due to excess corticosteroids. They cause obesity (very marked on the face and trunk), increased blood pressure, increased blood sugar, fragile skin and vinous stretch marks in the abdomen.

There are other tumors of the adrenal glands that are discovered casually on an ultrasound, a scanner (a CT scan) or an MRI performed for another cause and that produce no excess of any hormone. We call them incidentalomas and they usually operate if they grow or are large.

Finally, there are other less common tumors of the adrenal glands such as those that produce sex hormones or metastases from tumors of other organs (lung, breast, intestine or kidney).

How do you know if a tumor of an adrenal gland produces too many hormones?

It is suspected that a tumor of an adrenal gland is producing too many hormones because of the symptoms. It is known with certainty by doing special blood and urine tests. Sometimes it is necessary to repeat these analyzes several times.

How is adrenalectomy in Delhi done?

This surgery is always carried out under general anesthesia. During the intervention, one (the most normal) or the two adrenal glands can be removed. In some special cases, only the tumor can be removed leaving the healthy adrenal gland intact. Most of the time it is done laparoscopically, through small holes (5 and 11 millimeters) in the abdomen through which we introduce a mini camera and instruments. For one of them, the laparoscopic surgeon in Delhi extracts the gland with the tumor. This route is not very painful, allows quick recovery, has few complications and leaves very small scars. In some cases, it is not advisable to operate an adrenal tumor by laparoscopic route because it is suspected to be malignant or because it has an excessive size.

The anal fissure is a longitudinal tear that appears in the most distal portion of the anal canal and may require medical or surgical anal fissure treatment in Delhi. Its most frequent location is the posterior midline (90-98%), another less common location is the anterior midline (12% of those that appear in women and 7% in men). It has an equal incidence in both sexes and is more frequent in the middle age of life. Most are of unknown origin. The most likely explanation is an acute traumatism of the anal canal, defecation (large, hard stools) and rarely due to the explosive expulsion of liquid stools. The fact that the posterior wall of both the subendothelial space and the sphincter are less vascularized makes them more vulnerable to the location of the fissures. The transition to chronicity is due both to sphincter hypertonia and ischemia.

The presence of multiple fissures or in places other than those mentioned requires us to rule out diseases such as ulcerative colitis, Crohn’s disease, tuberculosis, syphilis, immunodeficiency syndrome … (it must be taken into account that more than half of the fissures secondary to intestinal inflammatory diseases occur in the posterior midline and are painful).

Symptoms

The main symptom of a fissure is a pain. It is an intense pain that is triggered by defecation, lasting in a variable way, from a few minutes to hours. There may also be bleeding, itching or itching and inflammation of the base of the fissure, which is often confused with hemorrhoid (“sentinel hemorrhoid”) and causes misdiagnosis if a laparoscopic surgeon in Delhi is not consulted.

The formation of an anal fissure results in the establishment of a “vicious circle” that hinders or prevents its healing: the existence of the fissure causes the defecation to produce pain, the pain causes a hypertonia or reflex spasm of the internal anal sphincter (responsible for the pain after defecation); hypertonia of the sphincter produces an alteration of the vascularization of the anal region that hinders the healing of the fissure, thus favoring the persistence of the “vicious circle”

Inspection

It should be done with great care because given the hypertonia of the canal it is very painful. The patient is placed in the left lateral decubitus position (Sims position), the anal margins are separated and the patient is asked to perform a Valsalva maneuver (it is often necessary to previously apply a topical anesthetic or oral analgesics). Rectal examination is contraindicated due to the risk of vasovagal syncope and even cardiac arrest; if it could be done, it would show sphincter hypertonia. Anoscopy and rectoscopy are only necessary when a secondary fissure is suspected.

Anal Fissure Treatment in Delhi

The therapeutic attitude will be different before an acute form or if signs of chronicity already exist (deep fissure, sentinel hemorrhoids, etc).

In the acute phase is when medical treatment has more chances of success. This consists of :

• Abundant intake of fluids
• Diet rich in fiber.
• Additives that contain fiber such as Plantago (Plantaben, cenat, etc.)
• Seat baths with warm-hot water.
• Topical ointments
• In patients with a high risk of incontinence: botulinum toxin type A

Can the fissure be operated?

It must be taken into account that medical anal fissure treatment in Delhi should always be attempted, even in chronic cases, where the percentage of success is smaller. The success rate of medical treatment is 60%.

The surgical choice of anal fissure treatment in Delhi is the internal lateral sphincterotomy. The intervention consists of the controlled section of the internal anal sphincter that eliminates the hypertonia of the same, disappearing the pain and getting the healing of the fissure in a few days. The operation is carried out by sedation + local anesthesia or spinal anesthesia under outpatient surgery.

Other techniques such as anal dilation have become obsolete or limited to very specific cases, especially after the demonstration of unsuspected sphincter injuries after anal dissemination in endoanal ultrasound studies.